No abstract

No abstract

Казанский государственный медицинский университет 2 Республиканская клиническая больница (Татарстан) Семейные случаи аутоиммунного гепатита и первичного билиарного холангита встречаются редко-по данным литературы, около 1%. В статье представлены семейные случаи аутоиммунных заболеваний печени у сибсов. Во всех случаях диагностирован синдром перекреста-сочетание аутоиммунного гепатита и первичного билиарного холангита.

The paper presents the results of a survey of 35 patients with liver diseases of various etiologies hospitalized in Gastroenterology Department of Republic Clinical Hospital in Kazan. The patients were distributed according to etiology: liver cirrhosis — 28 (80%), acute hepatitis — 5 (14.3%), after liver transplantation — 2 (5.7%). The patients underwent a complete clinical examination, and psychometric tests were additionally used to assess the stage of hepatic encephalopathy. Blood ammonium level was determined in all patients using the PocketChem BA PA-4140 blood ammonia meter. Connect-the-Numbers Test revealed encephalopathy in 97.1% of patients with liver diseases, while latent hepatic encephalopathy was observed in 47% cases. According to the West-Haven criteria, hepatic encephalopathy was diagnosed in 80% patients. Hyperammonemia was determined in 80% of patients with liver diseases. There was some relationship between the ammonium level and the stage of hepatic encephalopathy.

Ultrasound elastography is a method of instrumental diagnosing which allows rapidly and in a non-invasive way estimating the elasticity and histological properties of the tissue. The article presents a description of this method: the physical basis of the method functioning, the methodology of examination, the clinical significance in diagnosing fibrosis in patients with chronic liver diseases from the standpoint of evidence-based medicine, the advantages and disadvantages of the method, the factors which may distort the result, and the prospects of its use in clinical medicine. The possibility to use elastometry as a screening method and its economic significance are considered. In particular, the results of the studies conducted at Republic Clinical Hospital of the Republic of Tatarstan are presented. The average values of liver stiffness were calculated in patients with hepatitis of various etiologies and liver cirrhosis. The correlation was evaluated between the average liver stiffness and the Child-Pugh and FIB 4 indices, laboratory parameters (hemoglobin, total bilirubin, total protein, percentage of Quick’s prothrombin) and the portal vein diameter.